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* 1. First Name

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* 2. Last Name

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* 3. Pronouns

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* 4. Email Address

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* 5. Department Affiliation

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* 6. If you chose "Postdoctoral Clinical or Research Fellow", please indicate if you are registered as a Fellow with the Department of Psychiatry, University of Toronto

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* 7. Department

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* 8. Department Division

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* 9. Setting / Hospital

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* 10. Residents, Fellows and Graduate Students are encouraged to attend the Mentorship Breakfast, which will be held the morning of DPRD prior to the Keynote Address from 8:00 am to 8:45 am. If you wish to attend, check "Yes" then scroll down to complete the Mentorship Breakfast Survey below.

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* 11. Faculty volunteers are needed to share their academic experiences as mentors at the Mentorship Breakfast, involving roundtable discussions with mentees. The Mentorship Breakfast will take place prior to the Keynote Address at DPRD (8:00 am to 8:45 am). Please indicate if you are able to serve as a Mentor for this event.

If yes, please answer the following so that we can ensure a broad mix of mentors for the trainees.

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* 12. Are you an MD?

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* 13. Are you a PhD

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* 14. How many years since your first academic appointment?

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* 15. What is your area of research/expertise?

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* 16. Area(s) of experience that you would like to share?

Mentorship Breakfast Survey

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* 17. If you plan to attend the Mentorship Breakfast, please indicate your interest in the following topics ( 1=not interest at all, 5=very interested).

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How to get published
How to get a grant funded
How to get the most out of mentorship
How to get an academic job
How to balance work and life in academia
Discussion in a specific topic area (e.g. mood disorders, anxiety disorders, health systems)
Opportunities for networking and building collaborations
Equity and Gender in Academic Medicine

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* 18. If you are interested in a theme table discussing a specific topic area, please specify that topic area here:

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* 19. Dietary restrictions*- All registrants please indicate any restrictions.

*We will do our best to accommodate dietary requests
We strive to host inclusive, accessible events that enable all individuals, including individuals with disabilities, to engage fully. To be respectful of those with allergies and environmental sensitivities, we ask that you please refrain from wearing strong fragrances. To request an accommodation or for inquiries about accessibility, please contact Anastasia Paramonova at admin.psych@utoronto.ca with your request by May 15, 2023.

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